KULeuven/University Hospitals Leuven, Institute for Orthopaedic Research and Training (IORT), UZLeuven, Leuven, Belgium.
KULeuven/University Hospitals Leuven, Department of Nuclear Medicine and Molecular Imaging, UZLeuven, Leuven, Belgium.
Bone Joint J. 2019 Aug;101-B(8):915-921. doi: 10.1302/0301-620X.101B8.BJJ-2018-1569.R1.
Altered alignment and biomechanics are thought to contribute to the progression of osteoarthritis (OA) in the native compartments after medial unicompartmental knee arthroplasty (UKA). The aim of this study was to evaluate the bone activity and remodelling in the lateral tibiofemoral and patellofemoral compartment after medial mobile-bearing UKA.
In total, 24 patients (nine female, 15 male) with 25 medial Oxford UKAs (13 left, 12 right) were prospectively followed with sequential 99mTc-hydroxymethane diphosphonate single photon emission CT (SPECT)/CT preoperatively and at one and two years postoperatively, along with standard radiographs and clinical outcome scores. The mean patient age was 62 years (40 to 78) and the mean body mass index (BMI) was 29.7 kg/m2 (23.6 to 42.2). Mean osteoblastic activity was evaluated using a tracer localization scheme with volumes of interest (VOIs). Normalized mean tracer values were calculated as the ratio between the mean tracer activity in a VOI and background activity in the femoral diaphysis.
Significant reduction of normalized tracer activity was observed one year postoperatively in tibial and femoral VOIs adjacent to the joint line in the lateral compartment. Patellar VOIs and remaining femoral VOIs demonstrated a significant, diminished normalized tracer activity at final follow-up.
The osteoblastic bone activity in the native compartments decreased significantly after treatment of medial end-stage OA with a UKA, implying reduced stress to the subchondral bone in the retained compartments after a UKA. Cite this article: 2019;101-B:915-921.
人们认为，在膝关节内侧单髁置换术（UKA）后，固有间室的对线和生物力学改变会导致骨关节炎（OA）的进展。本研究旨在评估内侧活动衬垫 UKA 后外侧胫股和髌股间室的骨活性和重塑情况。
共前瞻性随访 24 例（9 例女性，15 例男性）25 例内侧牛津 UKA（13 例左侧，12 例右侧）患者，分别于术前和术后 1 年和 2 年进行连续 99mTc-羟甲基二膦酸盐单光子发射 CT（SPECT）/CT 检查，并进行标准放射学和临床结果评分。患者平均年龄为 62 岁（40 至 78 岁），平均体重指数（BMI）为 29.7kg/m2（23.6 至 42.2）。使用示踪剂定位方案和感兴趣区（VOI）评估成骨活性。将平均示踪剂值归一化为 VOI 中平均示踪剂活性与股骨干背景活性之间的比值。
术后 1 年，外侧间室关节线附近胫骨和股骨 VOI 的归一化示踪剂活性显著降低。终末随访时，髌骨 VOI 和其余股骨 VOI 的归一化示踪剂活性显著降低。
UKA 治疗内侧终末期 OA 后，固有间室的成骨骨活性显著降低，这意味着 UKA 后保留间室的软骨下骨承受的压力降低。
